OP0301-HPR Patient Adherence to e-Health Interventions for Remote Disease Monitoring in Chronic Arthritis
Authors: C. Van Lierde, M. Doumen, D. De Cock, S. Pazmino, D. Bertrand, R. Westhovens, P. Verschueren
Journal: Annals of the Rheumatic Diseases (2022)

Background Chronic inflammatory arthritides require lifelong follow-up and treatment. Electronic health (eHealth) could be used to remotely monitor disease, possibly improving patient self-management and lowering the burden of in-person consultations. For clinical use, it is important to understand adherence rates of patients with chronic arthritis to eHealth tools. Objectives To systematically review the literature on adherence to eHealth tools for remote monitoring of symptoms or disease activity in chronic arthritis. Methods We systematically searched the following databases: Embase, PubMed, Cochrane Central, CINAHL, Web of Science, Clinicaltrials.gov, and the International Clinical Trials Registry Platform (ICTRP). Eligible articles reported adherence rates to an eHealth tool in patients with rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), spondyloarthritis (SpA), osteoarthritis (OA), or gout. Included texts were screened individually. Finally, quality assessment was done with the Newcastle-Ottawa scale (NOS) and the PEDro scale. Results The literature search resulted in 7027 articles. After deduplication, 4219 articles were screened for eligibility, and 47 articles were included. We found highest adherence rates in studies applying electronic diaries (81.8%), followed by text messages (79.9%), web-based platforms (74.6%), activity trackers (73%), and smartphone applications (65.5%). Highest adherence was reported in studies on patients with OA (79.7%), followed by patients with gout (73.7%), RA (71.3%), ankylosing SpA (67%), and JIA (59%). Demographic characteristics did not seem to affect patient adherence. Based on frequency of data entering, a time interval of once-daily showed highest adherence rates (72.6%), followed by entering data more than once a day (72.3%) and once a week (67.7%), or longer (59.2%). Adherence declined with longer study duration. Conclusion Our literature review identified declining adherence levels with longer study duration, and highest adherence rates for patients with OA, making use of electronic diaries, and requesting once-a-day completion. OA studies had an overall shorter duration than RA studies, which could be an explanation as to why OA patients showed higher adherence. Lower adherence rates were reported in studies in juvenile populations, while older age did not seem to affect reported adherence. Figure 1. Linear regression model of adherence based on study duration per disease. X = study duration (days), Y = adherence (%). Y = -0.0332X + 71.84. Light blue = RA, yellow = OA, dark blue = JIA, red = Gout, green = SpA, white = &gt;1 disease Table 1. Included studies. Adh = adherence SA = smartphone app, ED = electronic diary, AT = activity tracker, OP = online platform, TM= text message. JIA= Juvenile Idiopathic Arthritis, PsA = Psoriatic Arthritis, SpA = Spondyloarthritis, OA = osteoarthritis, RA = Rheumatoid arthritis Study Disease EHealth Adh (%) Study Disease EHealth Adh (%) Study Disease EHealth Adh (%) Skrepnik, ‘17 OA AT/SA 91 AT 36 SA Beukenhorst, ‘20 OA AT/SA 75 AT 62 SA McKenna, ‘18 RA AT 43 Lee, ‘20 JIA SA 51 Nowell, ‘20 RA AT/SA 82 AT 72 SA Yu, ‘20 OA AT 99 Serlachius, ‘19 Gout SA 67 Heiberg, ‘07 RA ED 95 Zaslavsky, ‘19 OA AT/SA 85 Pers, ‘21 RA SA 67 Connelly, ‘11 JIA ED 71 Gossec, ‘18 RA OP 63 Heale, ‘18 JIA AT/SA 19 AT Connelly, ‘10 JIA ED 88 Walter, ‘14 RA OP 61 Reade, ‘17 RA SA 77 Bromberg, ‘16 JIA ED 66 Christodoulou, ‘14 OA OP 98 Bellamy, ‘10 OA SA 100 Bromberg, ‘14 JIA ED 66 Renskers, ‘20 RA/SpA OP 68 Seppen, ‘20 RA SA 69 Franceschelli, ‘19 OA ED / Tyrell, ‘16 SpA OP 67 Harbottle, ‘18 JIA AT/SA 17 SA Bingham, ‘19 RA ED 94 Martin, ‘21 RA OP 69 Pouls, ‘20 Gout SA 94 Connelly, ‘17 JIA ED 87 Kai, ‘19 OA OP 52 Colls, ‘21 RA SA 79 Stinson, ‘08 JIA ED 72 Richter, ‘21 RA OP 98 Brayne, ‘21 RA SA 41 Wilson, ‘13 OA ED 83 Broderick, ‘13 OA OP &gt;95 Austin, ‘20 RA SA 91 Jacquemin, ‘18 RA/SpA AT 88 Zuidema, ‘19 RA OP 71 Crouthamel, ‘18 RA SA 20 Elmagboul, ‘20 Gout AT 61 Barber, ‘18 RA OP 69 Nowell, ‘21 AS, OA, SpA, RA SA 55 Östlind, ‘21 OA AT/SA 88 AT Christie, ‘14 RA/SpA TM 98 Lee, ‘12 RA TM 73 Disclosure of Interests None declared